What determines the opportunities for individuals to develop a capacity for self-direction?

A capacity for wise and well-informed self-direction was identified in a recent post on this blog as one of five basic goods that a flourishing human could be expected to have. A flourishing human could be expected to have developed that capability because it is integral to the process of human flourishing. The nature of humans is such that as individuals mature, they have a unique potential to direct their own flourishing in accordance with values they endorse and goals they choose.

Wise and well-informed self-direction helps individuals to maintain other basic goods of human flourishing that are necessary to their pursuit of chosen goals.  The exercise of practical wisdom helps individuals to live long and healthy lives, maintain positive relationships, manage their emotional health, and live in harmony with nature.

How do individuals develop a capacity for wise and well-informed self-direction? It is possible to teach people about the virtue of practical wisdom, but it doubtful whether anyone has ever learned to exercise much practical wisdom without having responsibility to make choices in the real world. Individuals have the strongest incentive to learn how to make wise and well-informed choices in an environment that provides both great scope for freedom of choice and an obligation to accept responsibility for the consequences of the choices they make.

However, the opportunities for individuals to be well-informed also vary among countries depending on the knowledge that is readily available to them. Some of that knowledge is obtained through formal education, some is obtained on-the-job and some is absorbed through less formal interactions with family and friends. Individuals could be expected to have better opportunities to make well-informed choices if they live in countries where workforce skill levels are relatively high. That increases the chances that individuals will have easy access to relevant information for the important decisions they must make.

In what follows I consider how individual opportunities vary among countries, first in respect of freedom to choose, and then skill levels.

Freedom to choose

The accompany graph shows scores for perceived freedom and the Human Freedom Index for 126 countries for which matching data are available. Perceived freedom is the national average of positive responses to the Gallup World Poll (GWP) question: “Are you satisfied or dissatisfied with your freedom to choose what you do with your life?” The Human Freedom Index (HFI), developed by the Fraser Institute, incorporates 79 indicators of personal, civil and economic freedom to provide an objective measure of the state of freedom in each of the countries covered.

The graph shows that the countries ranked most highly using the HFI are also ranked highly in terms of perceived freedom. (Matching perceived freedom data is not available for Hong Kong, which was still one of the most highly ranked countries in the most recent HFI.) Switzerland, New Zealand, Ireland, Australia, Finland, Norway, Denmark, Netherlands, U.K. and Canada are presented as relatively free according to both indicators. However, perceived freedom also appears relatively high in some countries that more objective measures suggest are relatively unfree e.g. China. This may be a consequence of the binary nature of the GWP question. It would be more difficult for a survey respondent living under an authoritarian regime to tell a questioner that they are unsatisfied with their freedom to choose, than to give a moderately low score if asked to rate how much freedom they enjoy on a numerical scale. China’s score was close to the average in the 2010-14 World Values Survey (WVS) which asked respondents to rate on a scale of 1 to 10 “how much freedom of choice and control you feel you have over the way your life turns out”.

If you want a reliable indication of differences in human freedom among different countries it makes sense to use objective indicators, where possible. However, perceptions can sometimes provide useful information. For example, if women and men have different perceptions about the amount of freedom in their lives, that might reflect a gender equality issue. In fact, WVS data indicate that in most countries women and men have similar perceptions of the amount of freedom of choice in their lives. The few jurisdictions in which women rate the amount of freedom in their lives substantially lower than do men include Pakistan, Palestine and India.

Skill levels

The indicator of skill levels constructed for the Global Competitiveness Index (GCI) provides an appropriate basis for international comparisons of the knowledge that people are likely to be able to access readily in making important decisions. The GCI skills indicator incorporates perceptions of participants in a survey of executives coving questions relating to staff training, skillsets of graduates, digital skills of the population, ease of finding skilled employees and critical thinking in teaching, as well as education statistics such as years of schooling.

The top 10 ranked countries in terms of skill levels (for a data set of 118 countries) were Switzerland, Denmark, Finland, Netherlands, Germany, Norway, Sweden, U.S., N.Z. and U.K. If that list looks familiar it might be because it overlaps strongly with the list provided earlier of the countries ranked most highly in the Human Freedom Index. A simple regression shows a strong association between skills and human freedom (R2 = 0.50).

It seems unlikely that much of that association can be explained by direct causal links between freedom and skill acquisition. The most likely causal linkage is via the link between economic freedom and economic development. Economic development increases the demand for skilled labour.

Conclusion

Individuals have strong incentives to learn how to make wise and well-informed choices in countries where there is a great deal of economic and personal freedom. They are likely to have easier access to relevant information in countries with relatively high skill levels.

There is a strong overlap between the countries ranked most highly in the Human Freedom Index and the skill levels indicator of the Global Competitiveness Index. Both measures rank Switzerland, New Zealand, Finland, Norway, Denmark, Netherlands and U.K. among the top 10 countries. 

What determines opportunities for a long and healthy life?

This post is about the reasons why opportunities for people to live long and healthy lives are much greater in some countries than in others. In the preceding post the prospect of a long and healthy life was identified as one of five basic goods of a flourishing human.

So, which are the countries in which an individual chosen at random would be likely to have the best prospects of a long and healthy life? The OECD’s Better Life Index gives top ratings on health to Canada, New Zealand, Australia, Israel and Ireland. The health indicator used in that index may not be reliable, however, because it incorporates self-reported health along with life expectancy at birth to take account of the quality of life as well as its length. Self-reported health seems to be unduly influenced by cultural factors. For example, while life expectancy in Japan is among the highest in the world (more than 2 years greater than in Canada) less than 40% of people in Japan rate their health as good or very good (the comparable figure for Canada is 88%). 

Objective evidence published in The Lancet articles on Global Burden of Disease indicate that the difference between life expectancy and healthy life expectancy (the number of years people can expect to live in good health) is about the same in Japan and Canada (13 years for females and 10 years for males).

The Lancet study, which covers 195 countries and territories, indicates that healthy life expectancy (HALE) is highest in Singapore and Japan, but also relatively high in other high income countries. 

HALE is strongly correlated with life expectancy (LE). The difference between HALE and LE rises somewhat as LE rises: on average from 6.4 years for a country with LE of 50 years, to 10.8 years for one with an LE of 80 years. The difference is typically about 2 years greater for females than males, but LE for females is about 5 years greater than for males in middle and higher income countries.

The accompanying graph shows that substantial increases in HALE have occurred in many countries since 1990. The increases have generally been most pronounced in countries with relatively low life expectancy.

There seems to be little support for concerns that additional years of life are frequently not worth living. For countries with low LE in 1990, average increases in LE of 12 years were associated with increases in HALE of 10.5 years. For countries that already had high life expectancy in 1990, average increases in LE of 5 years were associated with increases in HALE of 3.7 years. It seems likely that many individuals would consider an additional year of life to be preferable to the alternative, even if accompanied by some ill-health.

Research seeking to explain differences in longevity among countries suggests that health care spending, higher income and education have beneficial impacts. An OECD study of 35 countries (mostly high-income) found that health expenditure made the greatest contribution to increased longevity (42 months) over the period 1990 to 2010, followed by education (15 months) income growth (13 months) and reduced smoking (5 months). The study found the impact of increased health spending to vary between countries, with relatively small gains in longevity experienced in the U.S. despite large increases in health care spending.

War and violent crime have a major impact on life expectancy in some parts of the world. For example, life expectancy among men who live in the north of Mexico apparently declined by about 3 years in the period 2005 to 2010 as a result of an increase in the homicide rate associated with drug wars.

Some of the important drivers of increased longevity have a common cause: health care spending has tended to account for a higher share of GDP as per capita GDP has risen. Econometric studies have suggested that this increased spending may be driven largely by demographic and technological factors, but income growth makes it possible.

The more fundamental determinants of opportunities for a long and happy lives are the factors contributing to the economic development that has led to high average income levels. There are virtuous circles involved in this process. As previously discussed on this blog, a plausible story of economic development also needs to take account of virtuous circles involved in interactions between culture and economic freedom. Where culture and economic freedom support markets, people have added incentives to gain reputations as being worthy of trust others in order to obtain the benefits of mutually beneficial exchanges. As people become more trustworthy and trusting, and more respectful of the rights others, they could be expected to support greater economic freedom. Economic freedom, and a culture supporting innovation, result in further economic development and economic development promotes a culture supporting greater economic and personal freedom. As part of this process, improvements in population health could be expected to contribute to higher labour productivity and further enhance income levels.

The economic development story outlined above implies that we should expect healthy life expectancy (HALE) to be higher, on average, in countries with higher levels of economic and personal freedom. In order to test that, HALE data for 155 countries have been matched with data from the Fraser Institute’s Human Freedom Index. The chart below shows that average HALE is about 10 years greater for the countries in the fourth quartile, with the highest freedom levels, than for countries in the first quartile, with the lowest freedom levels.

Conclusions

The countries in which a person chosen at random seems likely to have the best prospects of having a long and healthy life are characterised by high average income levels. Estimates of healthy life expectancy (HALE) published in The Lancet’s global burden of disease project are highest in Singapore and Japan. Since 1990, there have been substantial increases in HALE in most countries.

Health spending, income growth and education have contributed substantially to increased longevity. The more fundamental determinants of opportunities for people to have long and healthy lives are the cultural and institutional factors that have contributed to economic development. Evidence that high HALE is associated with high levels of human freedom supports an economic development story taking account of virtuous circles involving market freedom, cultures supporting freedom and health improvements.